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Division of Aging and Adult Services, Marin County Health and Human Services: Section on Aging Presentation
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Live Long, Live Well Division of Aging and Adult Services
Nick TrunzoDirector
"I have yet to see any problem, however complicated, which, when you look at it in the right way, did not become more complicated. "
Poul Anderson
Given limited resources, how will we choose the “most important” problems?
Health Issues
Income Needs
Transportation & Mobility
Cultural Competency
Legal Assistance
Home Care
Information & Assistance
Disaster Preparedness
Caregiver Needs
Elder Abuse
Decrease in Public
Funding
Growth in Older Adult Population
Housing
Social Isolation
Leading Causes of Death - Age-Adjusted rate, 2005
0 20 40 60 80 100 120 140 160 180
Diseases of the Heart
All Cancer
Cerebrovascular Disease
Chronic Lower Respiratory Disease
Unintentional Accidents/Injuries
Pneumonia
Suicide
Diabetes Mellitus
Infectious Diseases
Artery Diseases
Alzheimer's Disease
Mental Disorders
Liver Disease
Essential Hypertension & Hypertensive Renal Disease
Nephritis, nephrotic syndrome & nephrosis
Urinary Tract Infection
Parkinson's Disease
All Infant Deaths
Homicide
Deaths per 100,000 (Adjusted to 2005 DOF population projections)
430 deaths510
160 deaths
CONDITIONS, Age 60+*88% of older adults have one or more of the conditions below.
* Arthritis, high blood pressure, and high cholesterol are top three conditions*23.1% have severe visual problem or significant hearing loss
39.4%35.4%
28.3%
20.5%16.7% 16.0%
11.7%9.6% 7.9% 7.2% 6.3% 5.4%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Arthritis
Hypertension
High CholesterolCancer
Heart Disease
Significant Hearing Loss
OsteoporosisAsthma
Severe Visual ProblemDiabetes
COPDStroke
Source: 2001 Marin Community Health Survey
Reports of Alleged Abuse Received:2006 - 2009
YearElder
Reports
Dependent Adult
Reports Total
2006 312 108 4202007 431 146 5772008 505 179 6842009 545 179 724
IHSS PROGRAM GROWTHMarin County IHSS Program Growth
1,505
1,598
1,614
1,500
1,525
1,550
1,575
1,600
1,625
May 2008
1,505 cases
May 2009
1,598 cases
May 2010
1,614 cases
Marin County Population Projections 2000-2035
Age 2000 2005 2010 2015 2020 2025 2030 2035
60-69 20,052 26,400 36,700 45,000 46,900 46,100 40,200 34,000
70-79 15,058 14,500 22,800 26,600 37,200 44,100 44,800 47,700
80+ 9,537 11,400 16,400 18,700 22,800 30,000 36,800 49,700
Total 44,647 52,300 75,900 90,300 106,900 120,200 121,800 131,400
Pop Change 17% 45% 19% 18% 12% 1% 8%
Source: Senior Mobility Action & Implementation Plan (Draft) based on data from the Association of Bay Area Governments, September 2009
Marin County Older Adult Population Growth, 2000-2035
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
2000 2005 2010 2015 2020 2025 2030 2035
Year
Poul
atio
n 60-6970-7980+Total
70-79 and 80+ will continue to rise. Biggest pop jump is in the 70-79 age group.
2007 Census Estimates Older Persons Age 65 or Older, Marin County Source: American Community Survey 2007, U.S. Bureau of the Census
Total households in Marin: 99,627 one in four homes (27%) had a resident age 65 or older.
Total non-family households: 37,89181% were occupied by someone living alone.More than one-third (35%) of those living alone were older individuals age 65+
Total 65+ population in Marin: 37,818One in three (33% or 12,324 older persons) had a disability
2007 Census Estimates Older Persons Age 65 or Older, Marin County Source: American Community Survey 2007, U.S. Bureau of the Census
Median household income: $83,870Mean Social Security income: $15,838 Mean retirement income: $33,5014.7% of persons 65 or older fell below the federal poverty line in past 12 months
Residents Living Below the Federal Poverty Line (FPL)
19.9
%
14.5
%
6.8%
Elder Economic Index for Marin County vsFederal Poverty Line, 2007
The Elder Economic Index indicates income levels needed by an older person to be able to meet the cost of living of residing in Marin County. Using the Elder Economic Index, as opposed to the Federal Poverty Level, as a measure of economic insecurity will result in many more older adults living in Marin County to fall into poverty.
Elder Index (average)
Federal Poverty Difference
Single
Couple
$28,053 $10,210 $17,843
$36,828 $13,690 $23,138
Funding Comparisons by Fiscal Year(Total Area Agency on Aging State & Federal)
Fiscal Year 05-06 06-07 07-08 08-09 09-10
Total Funding
$1,431,691-2.0%
$185,229-3.7%
$461,388+2.5%
$99,001+0.4%
Support Services
NutritionProgram
$425,068 $408,717-3.8%
$421,460+3.1%
$449,962+6.8%
$477,521+3.5%
Family Caregiver
10-11estimate
$1,506,886 $1,473,997-2.2%
$1,474,815-0.1%
$1,461,353-0.9%
$1,156,785-19.2%
$186,357$186,500+0.1%
$186,500No change
$192,444+3.2%
$185,229No change
$161,097$145,262
-9.8%$95,262-34.4%
$98,580+3.5%
$99,428+0.4%
Strengths: Integrated Aging and Adult Services
Division of Aging & Adult Services
MULTI-DISCIPLINARY TEAM APPROACH:
Nurses
Social Workers
Student Interns
Mental Health Clinician
Community Volunteers
Support Staff
Adult Protective Services
Transition to Wellness:Medical Respite
In-Home Support Services
Project Independence:Hospital-Home Transition
Long-Term Care - Ombudsman
Healthy Housing:Nurse case-management
Chronic Disease Self Management
Information & Assistancemarin.networkofcare.org
ACUITY
COLLABO
RATION
Community Residents Post-Hospital Patients
Adult and Aging Services
Oversees the following programs and services:
Information and AssistanceAdult Protective ServicesNutrition ServicesFamily Caregiver SupportTransportationCase ManagementAdult Day Health/Alzheimer’s Day CareIHSSLegal AssistanceHome Care RegistryTransition to WellnessElder Abuse PreventionOmbudsmanOlder Worker/EmploymentVolunteer ProgramsVeterans Services
Administers the Older Americans Act and Older Californians Act as the federally mandated Area Agency on Aging (AAA) Responsibility to plan, coordinate and advocate for the development of a comprehensive, community-based service delivery system for older adultsCoordinates a Chronic Disease Prevention and Management ProgramCoordinates Elder Abuse Training Project
Planning Process-Identified Priority Areas 2009-2012
Aging in PlaceHome and community-based services
Transportation, nutrition, family caregiver, etc Health promotion, chronic care
Prevention programs: fall, isolation, disease prevention, and chronic care management
Social networksFamily, friends, neighbors, community
“Aging-friendly” neighborhoodsPedestrian-safe, housing close to services
Service AccessAwareness of information gateways: 457-INFO; 2-1-1; Network of CareService affordability and availability issues
Cultural competence Limited English-Proficient; LGBT; minority populations; rural communities
CollaborationFormal and informal provider networksReach specific communities through local senior centers, providers, and social groups
Planning Process-Identified Priority Areas 2009-2012
Identified Priorities Established Area Plan 2009-2012 Goals
1. Promote a community-based system of care that sustains the independence of older adults.
2. Increase opportunities for people to access information about community resources.
3. Improve the well-being of adults particularly those with special needs.
Major Changes
Elimination of Community-Based Services Programs (CBSP)
Alzheimer’s Day Care Resource CenterBrown BagLinkages Case ManagementRespite Purchase of ServiceSenior Companion Program
Total CBSP Funding Loss: $342,255
American Recovery and Reinvestment Act (Stimulus)
Nutrition: $74,0838,000 more meals served in Marin6 new dining sites at affordable senior housing
Senior Community Service Employment Program: $24,867
3 worker slots reinstated
Stimulus Funds End June 30, 2010
Area Agency on Aging Comparative Funding Source by Fiscal Year
42% 41%
14%
2% 1%
45%
53%
0% 1% 1%
0%
10%
20%
30%
40%
50%
60%
Federal OAA County State CBSP State GeneralFund
Private/Other
Source
Perc
ent o
f Fun
ding
FY 2009-10
FY 2010-11
Area Agency on Aging Funding Sources, Fiscal Year 2010-2011
45%
53%
1%
1%
Federal OAACountyState General FundPrivate/Other
Focus for Fiscal Year 2010-11
Collaborate with community partners to deliver services, develop innovative projects, and strengthen aging service system
Home and community-based services contractsPartnerships with MCF, Dominican
Focus for Fiscal Year 2010-11
Develop strategies to promote health, prevent disease, and manage chronic conditions
Explore evidence-based programs for replicationContinue to support DAAS chronic care initiatives
Chronic Disease Self Management ProgramDifferential Response TeamProject IndependenceTransition to Wellness
Focus for Fiscal Year 2010-11
Conduct forums to educate the public about critical topics and issues
Health promotion workshops and Medication ManagementHealthy Aging SymposiumCommission on Aging: Sample Committee objectives :
Community education forumsSustaining healthy lifestyles for family caregivers Senior Mobility Action & Implementation PlanAlcohol and multiple medication use
Articles in Great AgeDisaster preparednessResources for people with disability
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